Come Work With Us!

In compliance with Federal an State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national orgin, age, marital status, or non-job related disability.

Date of Application

Position Applying For

Social Security No.

Full Name

Birthday

List your addresses of residency for the past 3 years.

Current Address

How long?

Previous Address

How long?

Previous Address

How long?

Previous Address

How long?

Are you a U.S. Citizen or otherwise lawfully authorized to work in this country?

Yes

Have you ever been convicted of a felony?

Yes

If Yes, when?

(A conviction record will not necessarily ban you from employment. Such factors as age and time of the offense, seriousness and nature of the violation will be taken into account.)

Have you worked for this company before?

Yes

Position held

Date from

Rate of Pay

Are you now employed?

Yes

If not, how long since last employment?

Have you ever failed or refused a pre-employment drug/alcohol test given by a company where you never accepted employment?

Yes

Employment History

All driver applicants must provide the following information on all employers in the last 10 years.

The information provided concerning previous employers may be used to investigate the applicant's safety performance history.

(Note: List employers starting with most recent.)

Optional: Upload Resume

Upload File

Dates of Employment: From

Name of Employer

Contact Person

Address

Phone Number

Position Held

Pay

Reason for Leaving

As an employee, were you subject to the Federal Motor Carrier Safety Regulations?

Was the job a safety-sensitive position that was sbject to DOT drug and alcohol testing requirements?

Yes

Dates of Employment: From

Name of Employer

Contact Person

Address

Phone Number

Position Held

Pay

Reason for Leaving

As an employee, were you subject to the Federal Motor Carrier Safety Regulations?

Was the job a safety-sensitive position that was sbject to DOT drug and alcohol testing requirements?

Yes

Dates of Employment: From

Name of Employer

Contact Person

Address

Phone Number

Position Held

Pay

Reason for Leaving

As an employee, were you subject to the Federal Motor Carrier Safety Regulations?

Was the job a safety-sensitive position that was sbject to DOT drug and alcohol testing requirements?

Yes

Dates of Employment: From

Name of Employer

Contact Person

Address

Phone Number

Position Held

Pay

Reason for Leaving

As an employee, were you subject to the Federal Motor Carrier Safety Regulations?

Was the job a safety-sensitive position that was sbject to DOT drug and alcohol testing requirements?

Yes

Dates of Employment: From

Name of Employer

Contact Person

Address

Phone Number

Position Held

Pay

Reason for Leaving

As an employee, were you subject to the Federal Motor Carrier Safety Regulations?

Was the job a safety-sensitive position that was sbject to DOT drug and alcohol testing requirements?

Yes

Dates of Employment: From

Name of Employer

Contact Person

Address

Phone Number

Position Held

Pay

Reason for Leaving

As an employee, were you subject to the Federal Motor Carrier Safety Regulations?

Was the job a safety-sensitive position that was sbject to DOT drug and alcohol testing requirements?

Yes

Dates of Employment: From

Name of Employer

Contact Person

Address

Phone Number

Position Held

Pay

Reason for Leaving

As an employee, were you subject to the Federal Motor Carrier Safety Regulations?

Was the job a safety-sensitive position that was sbject to DOT drug and alcohol testing requirements?

Yes

Accident record for the past 4 years

Date Type of Accident Location Type of Vehicle Fatalities Injuries

Last Accident

Previous Accident

Traffic convictions and forfeitures for the past 4 years

Date Violation Location Type of Vehicle Penalty/Fine

Experience and Qualifications--Driver

Drivers Licenses: State/Licensing Authority License No. Type Expiration Date

Have you held a CDL in any state/licensing authority other than listed above in the last 3 years?

Yes

If yes; State/Licensing Authority

License No.

Have you ever been denied a license, permit, or privilege to operate a motor vehicle?

Yes

Has any license, permit, or privelage ever been suspended or revoked?

Yes

If the answer to any of the questions above is Yes, please give details.

Is there any reason you might be unable to perform the functions of the job (truck driver) for which you applied? I.E: but not limited to, lifting, loading, unloading, minor maintenance, tarping and securing of loads, fueling, and driving?

Yes

If yes, explain

Driving Experience

Class of Equipment Type of Equipment Dates: From - To Approx. No. of Miles (Van, Tank, Flat, Etc)

Straight Truck

Tractor & Trailer

Tractor & Two Trailers

Other

List any Truck Driving Schools you have attended, dates of completion, and other safety training:

Education

Choose highest grade completed

Check all that apply

High School Diploma

GED

College Degree

In case of emergency, whom should we contact?

Name Phone No. Relationship

In case of emergency, whom should we contact?

Name Phone No. Relationship

How long are you willing to be away from home?

How much home time will you need when you return?

How long are you willing to be away from home?

How many miles or hours are you expecting per week?

How much do you expect to make per week (gross)?

When are you available to start work for this Company?

To be read and signed by applicant

Print Name

Your Signature

Date

Thanks for submitting your application! We will be in touch soon!

This certifies that this application was completed by me, and that all entries on it and information on it are true and complete to the best of my knowledge.

I hereby authorize my current and previous employers, references, and any other individuals contacted by this company to release any past or present information requested, and I release all providers from all liability in responding to inquiries and releasing information in connection with my application.

I understand that any false, misleading, or incomplete answers or statements shall be considered sufficient cause for denial or termination of employment and/or authorization to drive.